Does Routine Urine Culture Testing Before Endoscopic Prostate Surgery Decrease Postoperative Urinary Tract Infection?
Muhieddine Labban1, William J O'Brien2, Kalpana Gupta2,3
1Department of Urology, Brigham and Women's Hospital, Havard Medical School, Boston, Massachusetts.
Urology Practice
|June 19, 2025
Summary
Routine preoperative urine culture (UCX) does not reduce postoperative UTIs in endoscopic prostate surgery. A history of positive UCX increases UTI risk, regardless of testing before surgery.
Area of Science:
- Urology
- Surgical Infections
- Medical Quality Improvement
Background:
- Endoscopic prostate surgery carries a risk of septic complications.
- Urology guidelines recommend preoperative urine testing, but the utility of urine culture (UCX) is unclear.
Purpose of the Study:
- To determine if preoperative urine culture (UCX) testing reduces postoperative urinary tract infections (UTIs) in men undergoing endoscopic prostate surgery.
Main Methods:
- Retrospective analysis of 22,825 men undergoing endoscopic prostate surgery (2015-2022).
- Evaluation of postoperative UTIs within 30 days.
- Identification of factors associated with preoperative UCX and postoperative UTI.
Main Results:
- Preoperative UCX was not associated with a decreased risk of postoperative UTI (aOR = 0.89; P = .29).
- A history of positive UCX within one year was the strongest predictor of postoperative UTI (aOR = 1.33; P = .001).
- Laser enucleation (LEP) was associated with lower UTI risk compared to transurethral resection of the prostate (TURP) (aOR = 0.56; P = .031).
Conclusions:
- Routine preoperative UCX testing is not associated with reduced postoperative UTI risk in endoscopic prostate surgery.
- Patients with a history of positive UCX remain at higher risk for postoperative UTI, suggesting a need for alternative management strategies, potentially including broader-spectrum antibiotics.
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